Surgery - General Physician
Company: Dane Street
Location: Harrison Township
Posted on: January 17, 2026
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Job Description:
As Physician Reviewer/Advisor for Independent Medical Exams
(IME), you will utilize clinical expertise and reviews insurance
appeals, and prospective and retrospective claims. The Physician
Reviewer will provide an interpretation of the medical necessity of
services provided by other healthcare professionals in compliance
with client specific policies, nationally recognized evidence-based
guidelines, and standards of care. MAJOR DUTIES AND
RESPONSIBILITIES: Reviews all medical records and addresses each
question posed by the client utilizing client specific criteria or
other nationally recognized evidence-based criteria Ensures that
the rationale for the determination is clear, concise, and contains
adequate supporting documentation to substantiate the decision
Identifies, critiques, and utilizes current criteria and resources
such as national, state, and professional association guidelines
and peer-reviewed literature that support sound and objective
decision-making and rationales in reviews; refrains from using case
studies, cohorts, and the like to make decisions due to their
limited sample sizes Provides copies of any criteria utilized in a
review with the report in a timely manner Returns cases on or
before the due date and time Makes telephone calls as mandated by
the state and/or client specifics Maintains proper credentialing
and state licenses and any special certifications or requirements
necessary to perform the job Attends all required orientation and
training Performs other duties as assigned including identifying
and responding to quality assurance issues, complaints, regulatory
issues, depositions, court appearances, or audits Board
certification required, active practice required PLEASE BE AWARE:
In the interest of the security of all parties, Dane Street will
never conduct interviews via text or request checks from candidates
for any reason including the purchase of equipment.
Keywords: Dane Street, Detroit , Surgery - General Physician, Healthcare , Harrison Township, Michigan
